Occasional syncopal attacks in young adults with AV block should alert physicians to the possibility of AV node tumors, potentially warranting pacemaker insertion to prevent sudden death.
AV node tumors merit consideration in unexplained AV block; this Level 5 case leaves open whether histologic evaluation or screening should change practice.
Histologic study of the conduction system of the heart of a 16-year-old girl who died suddenly demonstrated a benign mesothelioma of the AV node, with almost complete replacement of the structure by the tumor. Teh past history was unremarkable, except for few syncopal episodes at 9 and 11 years of age and during pregnancy. Immediately postpartum, she developed a 2:1 AV block and intermittent complete AV block. Six weeks later, during diagnostic work-up in the cardiac catheterization laboratory, she died suddenly. Electrophysiological studies during this work-up disclosed complete AV dissociation, with normal QRS complexes. The block was proximal to the His-bundle recording site, with a normal H-V interval. Occasional syncopal attacks in young adults should alert the physician to the possibility of this diagnosis and lead to pacemaker insertion.
No takes yet. Share an insight, caveat, or question.
Saroja Bharati (1976) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: